| NPI | 1578299277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILONG PHAM Owner, Cmo 310-570-0823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |